Posted
by
Soulskillon Friday November 29, 2013 @02:04PM
from the stop-buying-lottery-tickets dept.

KentuckyFC writes "Infectious disease condemns poor countries to an endless cycle of ill health and poverty. Now a powerful new model of the link between disease and economic growth has revealed why some escape plans work while others just make matters worse. The problem is that when workers suffer from poor health, economic output goes down. And if economic output goes down, there is less to spend on healthcare. And if spending on healthcare drops, workers become less healthy. And so on. So an obvious solution is for a country to spend more on healthcare. But the new model says governments must take care since the cost to a poor country can send the economy spiraling into long term decline. By contrast, an injection of capital from outside the country allows spending on healthcare to increase without any drop in economic output. 'We find that a large influx of capital is successful in escaping the poverty trap, but increasing health spending alone is not,' say the authors. And the amount required is relatively little. The model suggests that long-term investment needs only to be more than 15 per cent of the cost of healthcare. But anything less than this cannot prevent the vicious circle of decline."

'We find that a large influx of capital is successful in escaping the poverty trap, but increasing health spending alone is not,

Pretty much, we spend more money on HC in america than any other country yet our care is no where near good by any stretch of the imagination. Throwing more money at it like the current admin wants to do, according to this study anyway seems to be a waste of money

Oh we're quite 'healthy' - not at the highest level but more than healthy enough to be able to weather serious disease as best as possible. TFA is talking about real malnutrition / lack of clean water / lack of vaccines level healthy.

Now, how we go about spending money on 'health' is another topic that we've attacked numerous times and is much more complex. But, barring small pockets of severe poverty, we're pretty healthy.

Going back to TFA

How much cash does a country need to escape a poverty trap? Goerg and co say their model suggests that the money should be equivalent to halving the cost of disease treatment and prevention.

But this level of investment is not needed in the long term. Goerg and co say the same outcome can be guaranteed if the long term investment is equivalent to only 15 per cent of this cost.

I wonder if they're talking about nutrition / basic sanitation in theses costs. While not terribly high dollar, it's often hard to get levels of basic nutrition and clean water to really poverty stricken places and create the infrastructure to keep the resources up over time. That might be more expensive. Still and all it gives groups like the IMF a spread sheet number that they can plug in to force countries to do something other than create a mega dam for the Chinese.

Very true. Talk to people in the healthcare field and they'll be able to list tons of examples of wasted money. Any patient on medicaid/medicare gets more treatments, pills, devices, etc. because the hospital, dr, or specialist can bill for it.

Example: 80-something comatose man in the final stages of lung cancer being given a colonoscopy... just in case he might have ass cancer too. Seriously.

Healthcare is for-profit and must-CYA. Those are the two primary factors 90+% of the time. That's not to say there aren't doctors who care. Many do. But they're stuck working in a system that leaves them little choice but to go along if they want to continue practicing medicine (and paying off their insane student loans).

The last thing I want is the state telling me what I may eat, how much, when and where I must exercise, how much I must work, and when and where I may travel. Of course, all of this is required in order to 'live longer, work longer, and pay more tax.'

They do? It is? Shit, here I am and I've been doing it all wrong my entire life! Do you think if I ask my local government official he can still issue travel documents and papers retrospectively? Of course I'll need to find out who my local government official is first I guess. I never even knew...damn, this socialised medicine is tricky stuff!

Actually, the U.S. already spends more public money per capita on health care (via Medicare/Medicaid) than Canada does. So the problem cannot be attributed entirely to private health insurance.

I'm fairly certain the problem is the combination of private + public money used to pay for health care. If you go with completely public health care, there is just one payer. When you go with completely private health care, there is also just one payer (the person/insurer paying for a procedure). When you combine private + public, there are two payers. And just like government subsidized school loans end up driving up the cost of tuition, having two payers drives up the cost of health care. (I'm only "fairly certain" because the two conflate through a complicated mix of different patients paying different amounts for the same procedure, and doctors/hospitals cost-shifting in the accounting books to even everything out).

I live in Australia which has a hybrid UHC/Private system. Basically everyone pays for "medicare" (Which I guess would be called "medicaid" in the US) as a small addition to tax. Totally transparent, its just part of income tax and the contribution is income dependent. On top of that we have a private health system where you can get private health cover AS WELL which gives access to private hospitals (although in my experience the private hospitals are inferior to the excellent government ones, especially in emergency care). You have a choice here, but the govt system is largely excellent, however there might be waiting times to see specialists , sometimes in the months range for non essential stuff, and thats where private health cover is advisable. Fortunately private health insurance is well regulated and the doctor, not the health insurance companies , have final say in approving treatments.

Anyway, as you can imagine, when we have progressive governments, funding for the public system increases, and when you get conservative governments, that funding decreases.

But it backfires horribly to defund it, and ironically the actual costs increase.

I can giive an example. Under state labor, my local hospital had the 4 hour rule. In emergency, you would be seen within 15 minutes of ariving (or less if its urgent) , and within 4 hours either be seen by a doctor and sent home (maybe with medication or bandages or whatever) or admitted to hospital. In the case of borderline cases like Influensa, a patient would be sent to an Accute observation ward for overnight assessment. Its a great system that works brilliantly.

However in the last few years our state has had a conservative government that has systematically tried to defund the hospital. The end result is that waiting times have blown out to be multiple hours for non trauma cases in the emergency ward, and doctors are increasingly overworked and stressed out.

Last time I was admitted to emergency ward I was in with internal bleeding. Because I didn't *look* unhealthy it took 3 hours to see and diagnose me. This happened when I finally vomited blood and collapsed in the waiting room unconscious. I required surgery and a few weeks recovery. The doctor told me that if I had been diagnosed within half an hour of being admitted, it would have been a simple procedure and I would have been home within a day. As a result of underfunding, I cost the government *vastly more* in treatment costs then had I not. This is not a case of malpractice, the reality was the hospital was overworked and it took 3 hours to see me because thats how long it took to free up a doctor from all the other emergency cases.

It might seem paradoxical that properly funding universal healthcare is cheaper than not properly funding it, but it actually makes sense when you remember that prompt adequate treatment is almost always cheaper than trying to patch up some poor sod who's condition has been made worse by not treating it.

Private evil this private evil that.. look, insurance companies are manipulative and profit seeking, but having the state manage it is no better.

It should be obvious that a well-managed state will run a well-managed health care system, and a poorly-managed state will run a poorly-managed health care system. In fact, a poorly-managed state will have a poorly-managed private health care system.

Our government, run by the Republicans and their Democratic neocon equivalents, will manage it badly.

The problem is that in our political system, whoever has the most money for TV attack ads wins (most of the time), and corporate billionaires are the ones who can donate the most money to the two parties as a quid pro quo for advancing their interests. (In other countries that would be considered illegal bribery.) That's the main problem with the health care system. The health care industry poured hundreds of millions of dollars into the political campaigns.

Other countries -- every other country in the world -- pay far less per capita for their health care system. Some of them, like Canada, are pretty much like ours except they cost half as much and don't have a health insurance industry. The Australian and British health care systems are about as good as ours except that they cost roughly half as much as ours.

The Supreme Court case of Citizens United vs. FEC was designed to make it impossible to have electoral reform, and to insure that the 1% of billionaires will keep running this country for the indefinite future. I don't see any way out.

Unless you're making at least $100,000 a year, or have a million dollars invested cautiously, you'd probably be better off moving to another country.